'I Work At A Suicide Hotline—Here's What It's Like'

On World Mental Health day, as Theresa May appoints a minister for suicide prevention in England

By
Carly Breit and Ally Head

10/10/2018

S

It's World Mental Health day, and, as Women's Health launch their very own Instagram mental health guide, it's also been announced that Theresa May has appointed a minister for suicide prevention in England.

Health minister Jackie Doyle-Price will take on the new role with the hope of tackling the stigma that surrounds suicide—as it stands, the BBC reports that 4,500 people take their own lives every year.

This comes as the world's first ever global mental health summit is held with officials from 50 countries around the world.

So with that in mind, WH wanted to share a first-hand account from an anonymous crisis counsellor, who helps suicidal people every day.

WHAT IT'S LIKE WORKING AT A SUICIDE HOTLINE

I’ll never forget when the first call came into the National Suicide Prevention Lifeline on my first day as a crisis counsellor.

I had practised so much during my training, I’d role-played with other trainees, and I had listened in on more experienced crisis counsellors’ calls. Still though, I had no idea who would be on the other line—or how I would be able to help them. I wondered, 'What if I said the wrong thing?'

Then I picked up the phone.

'Thank you for reaching out. How can I help you?' I said, trying to use the same tone I would use to ask a friend about what was going on in their life.

For every call since the first, I’ve tried to do just that. When people think they’re the only ones with suicidal thoughts, I’m the voice that assures them they’re not. When callers just need to talk, I’m there to listen. And when they’re looking for a reason to live another day, I’m there to help them find it.

How I Got Here

I grew up in Alabama and I was homeschooled. I did a lot of learning on my own and I was immediately drawn to learning about mental health. It's one of the things in life that affects every one of us.

I knew that I had to choose a career path where I could make a difference every day, and the mental health field was the perfect place for me to do that. I studied psychology in college, graduated and made the move to New York City. I felt like I could help more people there than I could in my hometown.

I wasn’t sure what I wanted to do, but while searching, I found a crisis counsellor position at the Mental Health Association of New York City’s National Suicide Prevention Lifeline. It’s one of more than 150 local crisis centres around the country that offers 24/7 free and confidential emotional support to anyone who calls.

I read the job description and I knew immediately that it would be the perfect place for me to reach people at the moment when they needed the most help. After I submitted my resume and cover letter, went through an information session and an interview, I got the job as a hotline crisis counsellor.

Crisis Counseling 101

Next up: three weeks of training. Studying psychology for four years helped me understand some of the reasons why callers picked up the phone in the first place, but when I first started training, I had no idea how much I still had left to learn.

I learned that it wasn’t my job to swoop in and save the day. I wasn’t there to come up with a solution, or prove to someone that they shouldn’t feel the way that they do. I wasn’t there to show them the light at the end of the tunnel they thought would never end. Instead, it was my job to help them find it themselves. It was all about collaborating. It was all about connecting.

Sometimes, what you say is less important than what you don’t say. In fact, I think the most important thing you can do for a caller, or anyone you talk to with suicidal thoughts, is listen. We meet them where they are and step into their situation without judging or jumping to conclusions. That part’s not always easy.

'Callers sometimes hang up before we’ve talked about suicidal thoughts...it's hard to let that go.'

When my first call came—without another trainee on the other line—I picked up the phone. I greeted the caller, took a deep breath, and I listened.

My first caller was trying to get connected to treatment. (I’ve since come to find that many of our callers are looking for the same thing.) He had just been exposed to a crime, and he wanted to find a therapist in his area with whom he could talk about the impact that the crime had on him. Together, we found him a treatment plan that would help. And I have hope that it did.

With every call, I could feel myself becoming more confident. I learned how to develop a good rapport with every caller and use that relationship to help them open up to me about things they may have never even told their closest friends.

While they’re opening up, I evaluate their mental status, get to know their functioning, assess the risk of them hurting themselves or others, and figure out a way to startproblem-solvingg with them—all while listening intently, making them feel heard, and showing them they’re not alone.

My Hardest Call

Just like I’ll never forget my first call, I’ll never forget my hardest call, either. One night, I picked up the line and asked the caller, 'What sparked you to reach out today?'

'He sounded so cheerful throughout the entire call, even when he was telling me about his pain.'

It was a loaded question: His girlfriend had broken up with him, she was kicking him out of their house, and, I determined, he was actively suicidal. He had a plan to take his own life, and he was planning to go through with it.

Along with that, he had passively homicidal thoughts, which means that he had thoughts of killing someone, but didn’t have a specific plan.

I knew I had the tools to de-escalate the situation, but knowing what to do and actually doing it are two very different things. I was scared, but as I listened to him, I knew I had to put my fears behind me so that I could help him find real solutions to these haunting thoughts.

Some callers rush through the conversations, but he took his time, explaining his thoughts as clearly as he understood them. He somehow sounded so cheerful throughout the entire call, even when he was telling me about the pain he was feeling. He started calling himself “crazy” for having these suicidal and homicidal thoughts. I assured him that his thoughts were normal—that’s a vital part of crisis counselling, and it was the first step to making those thoughts manageable.

'We don’t do follow-up calls, so I’ll never really know if he went through with treatment.'

Together, we decided on something crisis counselors call a 'safety plan.' We found some of the warning signs, which some people call 'triggers,' that made him feel like he wanted to hurt someone or hurt himself. Thinking of his ex was one of them. We figured out some coping strategies, like calling a friend, so that he always had a plan when those warning signs would inevitably hit him.

By the end of the call, he accepted my referrals to get connected to more long-term treatment. We don’t do follow-up calls, so I’ll never really know if he went through with treatment. But I do know that through our call, he came to see that his thoughts weren’t crazy, he wasn’t crazy, and he most definitely wasn’t alone.

How I Learned To Let Go

It doesn’t always have a hopeful ending, though, and that part can weigh on me long after I leave work. Callers sometimes hang up the phone before we’ve really talked about their suicidal thoughts and come up with a plan. It’s hard not to let that get to me.

Some nights I feel like I didn’t do enough. But the reality of this job is that the call is not fully in my control—it’s a conversation, and it’s a two-way street. At the end of my shifts, I have to remember that I don’t know what the caller took from our conversation. It could have been all that they needed.

'My job is to form a connection with a person and show them unadulterated empathy.'

Even when my calls are incomplete, I remind myself that I did the best that I could, that’s all I can do. I have support from my colleagues to help me get through the hard days, and encourage me to keep going.

Whether you’re talking to a caller at a crisis counselling centre or just talking to a friend who is having thoughts of suicide, there’s a common misconception that you should rush to talk them out of killing themselves.

My job has taught me that that’s just not the case. Really, my job, and all of our jobs, is to form a connection with that person, to meet them wherever they are in life, and show them unadulterated empathy. Sometimes that will be enough to help them see the reasons they had for living that had been there all along.

If you or someone you know is having thoughts of suicide, call the Samaritans 24 hours, 7 days a week on 116123 or visit samaritans.org

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